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Year 5 path SW > Microbiology 1: CNS Infections And Meningitis > Flashcards

Microbiology 1: CNS Infections And Meningitis Flashcards

1
Q

What is the most frequent route of entry for pathogens causing CNS infections ?

A

Haematogenous spread

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2
Q

List 4 routes of entry to the CNS for pathogens

A 
Haematogenous spread (meningococcus, pneumococcus)  
Direct implantation (after surgery)
Local extension (from the ear)
PNS into CNS (rabies)
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3
Q

Which organism is a common cause of neonatal meningitis ?

A

Group B streptococcus

Floral bacteria in the mothers vagina

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4
Q

What organism commonly causes chronic meningitis ?

A

Tuberculosis

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5
Q

What organisms can cause aseptic meningitis ?

A

Enterovirus - coxsackievirus

Herpes simplex

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6
Q

Which organisms cause acute meningitis ?

A

N.meningitidis
Streptococcus.pneumonia
Haemophilus.influenza

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7
Q

Which N.meningitidis serotypes are there vaccinations for ?

A

B and C

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8
Q

Which virus transferred by vectors including birds and mosquitoes is becoming a leading cause of encephalitis world wide ?

A

West Nile virus

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9
Q

Name a bacterial cause of encephalitis ?

A

Listeria

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10
Q

Which organisms can cause encephalitis via local invasion ?

A

Amoebae

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11
Q

Which organism causes encephalitis via oral route ? (Eating cat poo 🤮)

A

Toxoplasmosis- e.g toxoplasma gonadii

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12
Q

What are the most common organisms responsible for brain abscesses ?

A

Streptococci

Staphylococci

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13
Q

What is the most common route of entry for organisms causing brain abscess ?

A

Local extension e.g from mastoiditis

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14
Q

Name a common spinal infection ?

A

Pyogenic vertebral osteomyelitis

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15
Q

What type of meningitis is suggested by this CSF sample ? What are the likely causative organisms ?

CSF appearance: clear
Cells: 0-5 leukocytes
Gram stain/antigen tests: negative results
Protein: 0.15-0.4 g/l
Glucose: 2.2-3.3mmol/m
A

Normal

No organisms

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16
Q

What type of meningitis is suggested by this CSF sample ? What are the likely causative organisms ?

CSF appearance: Turbid
Cells: 100-2000 polymorphs
Gram stain/antigen tests: positive results
Protein: 0.5-3.0 g/l
Glucose: 0-2.2 mmol/l
A

Purulent meningitis (bacterial)

Meningococcus
Pneumococcus
Listeria

17
Q

What type of meningitis is suggested by this CSF sample ? What are the likely causative organisms ?

CSF appearance: clear/slightly turbid
Cells: 15-500 lymphocytes
Gram stain/antigen tests: negative results
Protein: 0.5-1 g/l
Glucose: 2.2-3.3 (normal)
A

Aseptic meningitis

Coxsackie virus
Echovirus
TB

Could also be:
bacterial meningitis partially treated with ABx
Encephalitis
Brain abscess

18
Q

What type of meningitis is suggested by this CSF sample ? What are the likely causative organisms ?

CSF appearance: clear/slightly turbid
Cells: 30-500 lymphocytes/ some polymorphs
Gram stain/antigen tests: negative results (scanty acid fast bacilli)
Protein: 1.0-6.0 g/l (high)
Glucose: 0-2.2 (normal)

A

Tuberculous meningitis

Mycobacterium TB

19
Q

Culture and microscopy shows a gram +ve, alpha haemolytic diplococcus organism, what is the likely organism causing the meningitis ?

A

Streptococcus. Pneumoniae

20
Q

Culture and microscopy shows a gram -ve diplococci which is non-haemolytic, what organism is the likely cause of this meningitis ?

A

Meningococcus (Neisseria meningitides)

21
Q

Culture and microscopy shows gram +ve rods, what organism is the likely cause of this meningitis ?

A

Listeria monocytogenes

22
Q

Culture and microscopy shows a positive Ziehl-Nielsen stain what organism is the likely cause of this meningitis ?

A

TB

23
Q

India ink stain: shows orbit structures (yeast cells with surrounding halos)
Lumber puncture: high opening pressure
IN a patient with HIV

What is the likely causative organism of this meningitis ?

A

Cryptococcus Neoformans

24
Q

Which organism commonly causes meningitis in men who have sex with men (MSM)

A

Cryptococcus Neoformans

25
Q

Which drug is effective against Meningococcus, pneumococcus, haemophilus and e.coli ?

A

Ceftriaxone I.V

26
Q

Which drug is effective at treating Listeria ?

A

Ampicillin

27
Q

Which organism is most commonly associated with recurrent aseptic meningitis (Mollaret’s meningitis) ?

A

HSV-1 and HSV-2

28
Q

Which organisms are the most common cause of aseptic meningitis ?

A

Enterovirus (80%) - Echovirus, coxsackie virus

29
Q

common causes of encephalitis

A

rabies virus
arboviruses
prions
amoeba

30
Q

common causes of myelitis

A

poiovirus

31
Q

common causes of neurotoxin release

A

clostridium tenani

clostridium botulinum

32
Q

what is meningitis

A

inflammatory process of the meninges and CSF
neurological damage caused by:
- direct bacterial toxicity
- indirect inflammatory processes and cytokine release
- shock, seizures and cerebral hypoperfusion

can be classified into acute, chronic, aseptic (viral)

33
Q

list other causes of meningitis

A

listeria monocytogenes
group B strep
E. coli

rare:
TB, S. Aureus, T. Pallidum, cryptococcus neoformans

34
Q

describe the processes whereby septicaemia occurs

A

capillary leak - albumin and other plasma proteins lead to hypovolaemia

coagulopathy - leads to bleeding and thrombosis

metabolic derrangeent - acidosis

myocardial failure and multi-organ failure

35
Q

complications of TB meningitis

A

common in immunosuppressed
complications = tuberculosis granulomas
tuberculosis abscesses
cerebritis

there is leptomeningeal enhancement

36
Q

features of aseptic meningitis

A 
most common infection of the CNS 
coxsackie group B 
echoviruses 
usually in children <1 year 
self-limiting, resolves in 1-2 weeks
37
Q

what is toxoplasmosis

A

obligate IC protozoal parasite
spread via oral, transplacental or organ transplant route
causes severe infection in immunocompromised
affects organs including grey and white matter of brain, retinas, alveolar lining of lungs, heart, skeletal muscle

38
Q

which mode of screening is best to detect parenchymal abnormalities

A

MRI better than CT to look at functional tissue

39
Q

how should CSF infections be managed

A

within 30 mins - clinical assessment
after 1-2 hours - CFS analysis
24-48 hrs - CSF cultures

Year 5 path SW (106 decks)

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